And the controversial audit has confirmed the shocking state of the public health system.
The audit was finally published after three this afternoon by the Health Ministry after sustained public pressure and a directive yesterday from the Prime Minister.
The auditors say on the day they visited the Spanish Town Hospital in St. Catherine in June there was a bacteria infection outbreak at the facility.
The country was only previously told of bacteria infections at the Cornwall Regional, the Kingston Public and the University Hospital.
The report says on the day auditors visited the Spanish Town Hospital there was a Gram-negative organism outbreak at the institution.
Gram-negative infections refer to those caused by bacteria including the Klebsiella, Acinetobacter and Pseudomonas.
The revelation that auditors made mention of a bacteria outbreak at the Spanish Town hospital contradicts an assertion made by the country’s Chief Medical Officer Dr. Marion Bullock Duccasse.
Addressing a Jamaica House media briefing last week, Dr. Ducasse said the report does not speak to infection outbreaks.
Despite the finding of the auditors regarding an infection outbreak at the Spanish Town Hospital, the Ministry made an addition to the report where it sought to deny that there’s an outbreak at the facility.
Page 172 of the report made public today by the Ministry now says – “on the day of the audit there were a few neonates who had infections; however, this did not constitute an outbreak.”
The audit report was submitted to portfolio Minister Fenton Ferguson in late August.
Minister Ferguson held a media briefing on September 4 where he outlined what he said was an outline of key findings emanating from the audit.
Ferguson did not disclose that auditors said on the day they visited the Spanish Town Hospital there was a bacteria infection outbreak at the facility.
Regarding the Spanish Town Hospital Neo-Natal unit, the audit report also says – “hand-towels are in short supply hence expensive gauze is being cut for hand drying.This is “pennywise and pound foolish”.
According to the report, cleaning practices at the Spanish Town Hospital neo-natal unit do not conform to documented standards. The report says containers storing cleaning agents were not labelled.
Troubling findings are also contained in the report regarding the operating theatre at the Spanish Town Hospital.
Auditors say tiles on the walls do not allow for adequate cleaning, while operating lights are dull. According to the report infection control at the Spanish Town Hospital is being
The report also said Janitorial staff require training in the correct procedures of cleaning and the materials and concentrations of chemicals to be used.
Auditors also reported to the Ministry that the the Spanish Town Hospital operating theatre – there is “fungus” growing between the panes of glass in the window of the operating
Major shortages of essential items and improper hygienic and infection control procedures were uncovered at the Victoria Jubilee Hospital in Kingston.
That’s according to an Internal Audit conducted by the South East Regional Health Authority dated July 2015.
The hospital sees more than 70,000 women and 8,000 babies each year.
The areas audited were the Operating Theatre Suite, Fertility Control Unit, Neonatal Nursery and Maternity-Obstetric Unit.
The report reveals a shortage of the necessary Theatre Gowns in the Fertility Control Unit, nor were sterile supplies appropriately stored.
The report also states that Contracted Janitors neither adequately trained or equipped, nor do cleaning materials and methods conform to accepted standards.
It was also found that Anaesthetists were in some circumstances not wearing facial masks in operating rooms, nor was there specific personnel to ensure proper adherence to infection control procedures.
The report also states that no emergency buzzers or any form of communication for patients exist leaving shouting as their only option.
The hospital was also found to be in short supply of kidney dishes, forceps, foetal stethoscopes, kockers forceps, cord scissors, cord clamps, thermometers, episiotomy scissors and Linen.
Finally the Instruments are being soaked in antiseptic solutions not in keeping with standard procedures.
And the health and immunization status of the staff are not being monitored according to established schedules.
The National Chest Hospital was also audited in the Clinical Audit Report.
The report said the hospital had a compliment of only 90 beds despite seeing more than 3-thousand patients annually.
The facility is the only specialist hospital in cardio-thoracic care, treating conditions affecting the lungs, heart and other structures of the chest.
The area audited was the Operating Theatre Suite.
The report found that the recovery room had no beds, the Operating theatre doors needed to be repaired or replaced.
There was inadequate lighting. The disposal of waste did not conform to standard practice. There was a shortage of theatre clothes with current ones riddled with holes.
Face masks are not being worn in the operating room, and staff did not follow hand washing protocols.
On a rating scale of minimal being the lowest and substantial highest, the NCH’s overall rating was substantial for the management of the operating theatre and infection control.
However, the management of the inventory of equipment supplies and the preventative maintenance of equipment to maintain quality patient care as well as the procedure for the storage of sterile or high-level disinfected items were rated minimal.
Areas related to infection management and control, monitoring and evaluation of infection prevention, procedures for the cleaning of rooms between and after surgery, and cleaning of the surgical rooms were partial.
The procedures for the decontamination of instruments and other articles following surgery were completely absent.
The NCH has made news headlines in the past as concerns were raised relating to management practices and infection control at the facility.
No beds, no bathrooms, cracks in the floor,chemicals are not labeled, posing a danger to children.
This is the damning picture painted of the Princess Margaret Hospital in St Thomas.
The review of the Princess Margaret Hospital examines the Accident and Emergency Department, Operating Theatre Suite, and Maternity or Obstetrics Unit.
But the Operating theatre, where doctors make valiant attempts to save those who are required to go under the knife, and good hygiene is a necessity, was found to be in the most dangerous condition.
The audit notes that there are no beds. Instead, stretchers are used which is not suitable for post-operative care.
In addition to the complete absence of bathrooms, the audit highlights that the Operating Theatre, where every single cut could mean dire consequences, there are missing bulbs which makes “focusing difficult.”
There are cracks in the floor of the Operating Room and the Central air conditioning unit is out of service, the audit notes.
Meanwhile in the accident and emergency unit, the report notes that “cleaning procedures and methods are not in accordance with standards.”
And disturbingly, chemicals are not labelled. The audit notes that these chemicals need to be stored away from children.
Medical records are not being completed according to standards in the A and E unit.
And in the Intensive Care Unit or ICU, it notes that there is no changing room or shower for staff.
According to the audit, there are also no dedicated ICU beds.
Beds from the wards are being used.
However, the report laments that these beds are not able to be tilted to have the necessary changeable positions for efficient patient care and resuscitation.
An audit into operations of the Cornwall Regional Hospital noted several breaches of accepted standards and the use of adhoc systems to address challenges faced due to shortages of supplies.
That’s according to an Audit conducted by the Western Regional Health Authority between April and June 2015.
Report states that disposable scrub packs were not provided on a scheduled basis and when out, staff would resort to using Garbage bags.
It was also reported that clinicians would don latex free non sterile gloves under pair of sterile latex gloves for those with latex allergies.
The report also established that an absence of a structured stock monitoring system, and a lack of a dedicated officer to manage the stock, resulted in inadequate controls.
The audit also revealed that the regional authority was failing to carry out the requisite repairs and maintenance on critical equipment, or provide replacements in a timely manner.
The report also revealed that several items intended for single or double use had to be sterilized and reused on many occasions due to shortages.
This the report notes increases the risk of transmitting fatal infections.
Another serious concern raised in the audit was control of ill members of staff.
It revealed that staff who are identified as “not feeling too sick” are allowed to work albeit not in operating theatres.
The report also states that those who have been absent from work due to illness, provide no medical certificate of fitness to prove being fit for work.
Additionally, the report notes there were no systems in place to ensure that both staff received stipulated vaccines.